Introduction: To investigate the questions that Muslim patients, embryologists, paramedics, clinical counsellor and doctors may have pertaining to the compliance of Assisted Reproductive Technique (ART) to Shari’aa.
Methods: As a preliminary study, an open-ended survey was administered to participants. Participants for the survey comprised of 21 patients, 2 embryologists, 2 doctors, 4 paramedics and 1 counsellor.
Results: Data analysis showed that most of the participants posed questions that fall into six classifications which are: Munakahat (Family Law), social Hukm, Fiqh Ibadah, Fiqh Qadha (Islamic Hukm), General Fiqh and Usul Fiqh.
Conclusion: It is clear that even though the participants were rather familiar with some of the existing Fatwas pertaining to ART and IVF in Malaysia, there are still remaining doubts which need to be clarified. This indicates that there are challenges faced in seeking and providing ART treatment to Muslim patients. This needs to be addressed perhaps in the form of Shari’aa-compliant guidelines to provide a clear explanation of each process and procedure in fertility treatment.
Introduction: To analyze the ART outcome and factors associated with successful ART treatment for infertile couples in a newly set up medical university IVF centre. Methods: A six-month cohort study of patients undergoing their first assisted reproductive technique cycle was conducted at IIUM fertility centre, Kuantan (from 15th June until 31st Dec 2009). Outcome measures include clinical pregnancy rate, ongoing pregnancy rate, take home baby rate and complications rate. Results: Fifty-five first cycles of IVF/ICSI were studied. Mean embryo per transfer was 2.1±0.8. Four patients were pregnant (23.5%) from a single embryo transfer (SET). Clinical pregnancy rate was 30.9% (17/55). Ongoing pregnancy rate was 23.6% (13/55) and take home baby rate was 21.8% (12/55). There was only one twin pregnancy. Nine patients (16.4%) had OHSS whereby 77.8% were mild and 22.2% were moderate. Conclusion: Take home baby rate at the IIUM fertility centre is comparable to most established ART centres in Malaysia considering that this is only the first year of operation.
Introduction: The mainstay of treatment of depression relies on pharmacological and psychological treatments. On top of that, evidence also recognizes the vital role of spirituality for human wellness which leads to growing interest in its utilization to treat depression. However, research on spirituality among Muslims in relation to depression is relatively scarce. The aim of this study is to explore the understanding of spirituality among Muslim patients with depression, and to explore their spiritual needs.
Methods: This is a qualitative study conducted on 10 depressed Muslim patients at the UKM Medical Centre. Purposive sampling was done to ensure diversity of subjects. Individual in-depth interviews were conducted using semi-structured questionnaire guidelines. The data were transcribed verbatim and analysed using a thematic approach.
Result: Out of 10 patients, almost all of them expressed spiritual needs. Two major themes emerged in relation to the spiritual needs which are (i) religious needs; need for worship, religious knowledge and guidance, religious reminders, and (ii) existential needs; need for calmness, sensitivity and empathy, self-discipline, certainty, hope , physical help, ventilate and meaning of illness. These needs are essential for patients during the time of crisis.
Conclusion: The majority of patients expressed spiritual needs which are required during the process of recovery and this provides an opportunity to incorporate spiritual approaches in the treatment of depression. However, more studies are needed to demonstrate its scientific basis and to design an effective psycho-spiritual treatment modality so that the ‘holistic’ or ‘biopsychosocial-spiritual’ treatment can be integrated by health care professionals to those in need.
Study site: hospital database at the department of psychiatry (in-patient and outpatient), Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
The ultimate goal of treatment of glottic malignancy is eradication of the cancer and preservation of maximum function. Ideally this would mean return of normal speech, respiration and deglutition. The foundation of vertical partial laryngectomy (VPL) is based on the knowledge of laryngeal anatomy and an understanding of how cancers invade the larynx. The VPL surgery of the glottic cancer is based on oncological sound principles, which will be further disscussed in this article. For the purpose of description we briefly presented 3 of our cases that underwent vertical partial laryngectomy for glottic cancer.
Introduction: This study aims to build a standardization method for preparation of effective powder from
FSA and to quantify diosgenin in FSA. Methodology: One kg of FS were used in this study. Setting: BMS, KOM
and KOP, IIUM Kuantan campus. FS were washed with distilled water to exclude any foreign matter, and
were then air dried. FS-powder were put in distilled water in a ratio of 1 g of powder in 20 ml of distilled
water and were shaken at room temperature for 24 hours. Ten mg of hydrolyzed extract sample was diluted
in 10 ml volumetric flask with methanol for 15 minutes. Chromatographic estimation was performed using
an equilibrated reverse phase Eclipse XDB-C18 column (particle size 5 µg, 4.6 mm x 150 mm). Results: One
gram of FSA extract was hydrolyzed to produce sapogenins and 46.6% was recovered. A calibration curve
that was constructed based on five dilutions of diosgenin standard at concentrations of 2, 5, 10, 20, 30 and
50 ppm produced a linear graft (r = 0.999). The concentration of diosgenin in FSA extract as calculated using
the regression analysis was found to be 29.66 µg/ml, 13.81 % w/w on dried weight basis. Conclusion:
Preparation and standardization of effective powder from FSA are the corner stone of many scientific
researches in IIUM and Malaysia. Diosgenin is available in the FSA in adequate concentration. The adequate
amount of diosgenin in the FSA will guide us to do further study in the way of preparation of a natural
product that can be used in the field of reversible anti-fertility therapy.
Leaves of Thottea dependens have been used as folk medicine in Malaysia for the treatment of
several conditions involving pain and inflammation with accompanying pyrexia. However, there is no scientific
evidence for its effectiveness to treat fever. Hence, the purpose of this study was to evaluate the anti-pyretic
activity of methanol (MeOH) and aqueous (Aq) extracts of T. dependens leaves in albino mice (ICR strain).
Orthodontic tooth movement is a complex process involving tooth and periodontal
tissue, which release enzymes and biomarkers. The aim of this study was to investigate enzymes
activities of salivary fluid during orthodontic treatment, (Copied from article).
Streptococcus pneumoniae (S. pneumoniae) is a gram-positive diplococci belonging to the genus Streptococcus and it is a well-studied pathogenic bacterium. Pneumococcal diseases such as otitis media, pneumonia, sepsis and meningitis caused by pathogenic strains of S. pneumoniae still brought significant mortality and morbidity worldwide. The pathogenicity of S. pneumoniae is exerted by various virulence factors and one of it is the enzyme hyaluronate lyase. Hyaluronate lyase plays a major role in
the invasive capability of S. pneumoniae. Its mechanism of action and crystallographic
structure have been determinedbut its regulatory mechanism is still poorly understood.
Drawing connections between the nutritional behaviour and invasive property of S.
pneumoniae, CodY regulator is hypothesized as a potential hyaluronate lyase regulator.
This work was aimed to construct CodY deficient mutant of S. pneumoniae to form
foundational work for the study of CodY regulatory effect on hyaluronate lyase.
Burkholderia pseudomallei is the causative agent of melioidosis, an
infectious disease endemic in Southeast Asia and northern Australia. Cases have been
reported in Pahang, Johor Bahru and Kedah. The disease is difficult to combat as B.
pseudomallei has shown resistance to various antibiotics and much is still not understood
about its pathogenicity. It is suggested that investigating the bacterium hypothetical
proteins may provide potential new targets for the development of antimicrobials. The
gene of interest in this study, BPSL2774, encoding BPSL2774 hypothetical protein, is a
target gene that was predicted as essential using transposon-directed insertion site
sequencing technique (TraDIS). We aimed to express and purify soluble GST-tagged
BPSL2774 protein at sufficient concentration for future functional assays. (Copied from article).
Recurrent oral ulcer is a chronic inflammatory condition characterized by mucosa
ulceration, which was believed to have bacterial etiology. Streptococcus mutans is one of the
bacteria which have been implicated in this case; it is gram-positive bacteria that reside in the
biofilms on the tooth surfaces. The aim of this study was to evaluate Streptococcus mutans content
in saliva of recurrent oral ulcer patients and its role as a prognostic factor. (Copied from article).
Introduction: The aims of this study were to assess the differences in the percentages of abnormal morphology between the epididymal and testicular spermatozoa of mature male offspring mice whose mothers were injected with various doses of lead acetate during gestation. Materials and Methods: Seventy two healthy female mice were divided into three major groups according to the number of injections involving 1, 2 or 3 injections at 8th day; 8th and 13th days; and 8th, 13th and 18th days of gestation period, respectively. Each major group was subdivided into four minor groups according to the dosage of lead administered (0, 25, 50 and 100) mg/Kg. Results: The percentages of abnormal morphology of epididymal and testicular spermatozoa were studied and the data were statistically analyzed. The results of this study proved that an increased number of injections and/or dose of lead acetate injected to the mothers during gestation cause an elevation in the percentage of abnormal morphology of both epididymal and testicular spermatozoa of the male mice offspring. Conclusion: In conclusion this study demonstrated that lead acetate when exposed prenatally have toxic effects on the sperm in the offspring male mice resulting in abnormal morphology of spermatozoa. The most likely causative factor is disturbances in the phase(s) of spermatogenesis and/or spermiogenesis.
Introduction: The purpose of this study was to decide on the relation between types of mixing and the porosity of diameter (1-100) µm and compressive strength of RMGIC. Methods: Fifteen specimens 6mm height and 4mm in diameter were prepared for each type of luting cement and were stored in distilled water at 37° C for 24 hours. The compressive strength was determined. The fractured surfaces of 10 randomly selected specimens of each cement type were analyzed using SEM at 250 times magnification, and five photomicrographs were taken at five random places. All the photomicrographs were analyzed using image analyzer software to determine the amount and size of porosity present. Results: There was no significant difference in compressive strength between different mixing methods, but it had a significant impact by increasing the percentage of porosity of diameter (1-100) µm in diameter of RMGIC. There was no linear relationship between compressive strength and porosity (1-100) µm in diameter for both types of luting cements (P>0.05). Conclusion: No significant differences in compressive strength were found using different mixing methods. The size and number of porosity in the specimens of encapsulated cements were greater than those of hand-mixed cements. The porosity (1-100) µm in diameter and the compressive strength bore no linear relationship to each other.
Introduction: The purpose of this in vitro study was to evaluate the effect of thermocycling on the compressive strength of selected luting cements. Material and methods: 5 types of luting cements were tested. A total of thirty cylindrical specimens measuring 6mm in height and 4mm in diameter were prepared for each type of cement which were then divided into two groups ie Group 1: Exposure, and Group 2: Control. Both groups were stored in distilled water at 37°C for 24 hours. Group 1 was subjected to 500 cycles in a thermocycling baths of 5ºC and 55ºC with 20 seconds in each bath. Group 2 was not exposed to thermocycling procedure. The compressive strength for each cement type was determined by using a universal testing machine. Results: Resin adhesive cement had the highest compressive strength; followed by conventional glass ionomer cement (GIC) whilst resin modified GIC was the least. Thermocycling had no significant effect on the compressive strength of RelyXTM ARC and Fuji I (p>0.05), but a significant effect on Fuji I CAPSULE, Fuji CEM, Fuji Plus CAPSLUE (p
As it is known; the majority of the human subjects has two renal arteries arising from the abdominal aorta; each will supply one kidney but in 30% of individuals, certain variations can be found. Accessory renal arteries constitute the most common and clinically important of these variations. For our case report, we are presenting one of these different variations that can be found in the blood supply of the kidneys. During dissecting the abdomen of an approximately 65 years-old male cadaver, multiple variations were found. There were double right renal arteries with prehilar branching of the upper renal artery. We found also that the right renal vein ascended upwards obliquely before ending in the lateral aspect of the inferior vena cava. Variation in the renal vessels is relatively common, especially multiple renal arteries, and can go smoothly without any abnormalities with the function of the kidney, but in some situations like renal transplantations, vascular reconstructions, and various surgical and radiological diagnostic techniques, the study of the anatomy of these variations is of crucial importance to decrease the patient morbidity during surgical procedures.
Thyroglossal duct cyst is the most common upper neck midline lesion in children. Approximately 1% of
thyroglossal duct cyst undergoes malignant transformation. Calcification which is a marker of malignancy
almost always points out to papillary thyroid carcinoma. Benign case of calcified thyroglossal cyst maybe
undiagnosed or under reported. We report a case of a 5 year old girl with a benign calcified thyroglossal
duct cyst, a fourth case in world literature. Here the differences between a benign and malignant
thyroglossal duct cyst are discussed.
Introduction: The goal of the present study was to examine the effect of alcohol consumption on sperm count and motility and the morphological changes in the seminiferous tubules of parent mice and their offspring. Methods: Animals were divided into two groups, Group 1 (alcohol group) of twelve male and twelve female mice, were given a daily dose of (3 g/kg body weight as 25%, v/v) ethanol by gastric gavage for four and eight weeks. Group 2 (control group) also of twelve male and twelve female mice; received normal access of food and water. After four weeks of treatment, the males and females in each group were allowed to mate, and ethanol treatment continued for up to another four weeks. Twelve male offspring from group 1 and twelve male offspring from group 2 were selected randomly and allowed to become mature. Male parent mice were killed at the 4th and 8th weeks of treatment, and their male offsprings were killed when they reached maturity age. Results: Physiological examination of the sperm solution showed that there was a significant decrease in sperm count and motility after 4 and 8 weeks of ethanol treatment in parent male mice, but this decrease was not significant in their adult offspring. Furthermore, histological investigations indicated testicular lesions in the parent male mice and their adult male offspring. Conclusion: Alcohol abuse has deleterious effects on the testes structure and on the sperm count and motility of the epididymal spermatozoa of both parent mice and their offspring.
This is a cross-sectional study to evaluate the outcome of posterior cruciate ligament
reconstruction in chronic injuries using ipsilateral Bone-patella tendon-Bone graft in nine patients, between January 2000 and January 2003 at our institution.
Education and training in disaster medicine is an ongoing process to all categories of personnel involved.
In addition to the collaborative inter-professional table top exercises, regularly conducted field exercise drills offers the best form of training. Currently in most countries there is no standardized curriculum
for the training of disaster management from the medical perspective. It is imperative that the concept of disaster medicine and its principles should be a component in the undergraduate and postgraduate
curriculum of Medical and Allied health related programmes.
Introduction: The goal of palliative care is the provision of the best quality of life (QOL) for terminally ill
and dying patients. Advances in medical treatment has seen an increase in overall survival of all stages of
malignant diseases. This includes advanced and/or inoperable malignancies where management is mainly
palliative involving different modalities. Methods: We designed a cross-sectional descriptive study of
surgical patients in a palliative care unit in a 1000-bedded teaching hospital in Kuantan, Malaysia.
Objectives of this study are: to study the demographic characteristics and indications for admission of
surgical patients in palliative care unit, to study the options of treatment modalities and their
complications, to identify the barriers in decision making in surgical treatment and finally to objectively
assess the quality of life of these patients by utilizing QUALITY OF LIFE (WHOQOL) –BREF –questionnaire.
Results: One hundred and one eligible patients (53%) male, (47%) female of mean age of 54yrs, majority
Malay and Chinese patients were included in the study. All patients had malignancies and they were Breast
(30%), Lower gastrointestinal (GI) (24%), (18%) upper GI, (15%) hepato-biliary, and (7%) pancreatic cancers.
Thirty two percents of patients had emergency treatment while the rest had supportive treatment. Barriers
to decision making were mainly due to patient factors in 71%, while 12% was due to the disease presenting
at an advanced stage and 15% due to limitation of care. The final results of overall quality of life rating
were shown as poor (1%), neither poor nor good (42%), good (52%) and very good (2%). Conclusions:
Palliative care and end of life decision making from surgical point of view is a delicate issue. Like all other
fields in medicine, palliative care must be evidence-based with specific goal directed therapy. Our study
shows that we are able to positively impact the quality of life in more than two thirds of our patients. Our
aim is to achieve 100% success. As such, it is imperative to inculcate the goal of palliative care to all grades
of health care personnel. ‘To cure sometimes, To relieve often, To comfort always’ should not be mere
words.